Breast Physiology

Question 1

• What causes maturation? Reproduction? Nutrition?
• 3 benefits for mom with breast feeding? Hormone?
• Lobules contain what? Do what?
  1. ) Embryogenesis: Establish rudamentary gland from? Via?
• No PTHrP? PRL in neonate?
  2. ) Puberty: Ductal morphogenesis via? (2) Effects?
  3. ) Pregnancy: Lactogensis 1? Lacto 2? Lobules? Alveoli? Hormones needed?

Answer 1

• E2, P, PRL
  1. ) Less postpartum bleeding (oxy) 2.) wt loss 3.) Less blood loss (prl)
• Alveoli; milk production
  1. ) Mammary mesenchyme; PTHrP
• Amastia; lactation
  2. ) E2 = Ductal with GH/IGF1; P = Lobular; Grow/regress TDLU, increases risk of breast cancer
  3. ) Initiation of secretory capacity; Copious milk production; increases; differentiate; High PRL and progesterone

Question 2

• Progesterone fall occurs when?
• Milk secretion: Causes by? (2)
• Milk ejection: Caused by? (2)
• Suckling/condition increases what? Stress does what? High weight leads to?
• With delivery: Milk volume? Tight junctions? sIgA?
• D1 - 5? (4)
• > 5?
• Milk removal important for? (3)

Answer 2

• PLacenta leaves; pro blocks milk secretion
• PRL pulses; milk removal
• Oxytocin stim. myoepi to contract; suckling inhibits Dopa and maintains PRL
• Oxytocin; breaks loop; Less lactation
• Increases; Close; Increase
• Open TJ’s = High leukocytes/ sIgA/ Lactoferrin
• Tight junctions close and milk volume increases
• Glandular integrity; closes TJ’s; maintains lactation
• High oligosacharides

Question 3

1. ) Clostrum: High what? (3)
2. ) Transitional: d 2-14: High what? (3)
3. ) Mature: High what? (5)
   - Foremilk? Hindmilk?
   - Atropy for kid breast feeding?
   - Babies should be breast fed within?
   - Growth difference for bottle feeding? Composition difference?

Answer 3

1. ) IgA; Lactoferrin, protein
2. ) Lactose, fat, calories
3. ) Water, lipid, lactoferrin, zn, iron, sIGA
   - Low fat; high fat
   - Less
   - 1 hour
   - Same 3 mo; then increase; more protein

Question 4

Twins:

• Percent chance?
• Dizygotic: Done how? % of twins? Due to?
• Mono how? 1-3 d? 3-8? 9-12? 13-15? Most common?
• US: Lambda sign? (2) T sign?
• If you can see chorion? Clear space?
• TTTS: Occurs in what? Due to? Recipient? (3) Donor?

Answer 4

• 1/50
• 2 sperm; 2 eggs; 70%; ART
• 1 sperm then divide; di-di; mo-di; mo-mo; conjoined; mo-di
• di-di; mono-di
• di/di; mo-di
• mo -di; unbalanced flow through vessels; polyhydraminos, incre bladder, HF; oligohydraminos